Per Sri M.V.L.Radha Krishna Murthy, Member:

                This complaint is filed under section 12 of the Consumer Protection Act, 1986 by the complainant praying to direct the opposite parties to pay a sum of Rs.1,65,000/- (comprising of Rs.1,00,000/- insured amount, Rs.25,000/- towards mental agony, Rs.5000/- towards legal expense, Rs.10,000/- compensation and expenses, Rs.25,000/- towards interest) for subsequent interest on the amount claimed at 12% p.a. from the date of complaint till realization.

The brief facts of the case are as follows:

                One Vanukuri Siva Brahma Reddy is the husband of 1^st complainant and father of complainants 2 and 3.  During his life time, he joined as member in 3^rd opposite party society.  Accordingly 2^nd opposite party issued a passbook in favour of deceased Siva Brahma Reddy.  Later Siva Brahma Reddy died in February, 2009 leaving behind the complainants as legal heirs.  Opposite parties 2 and 3 have collected premium amount, covered risk to a tune of Rs.1,00,000/- vide policy No.150800/47/08/43/00000017 on account of death of policy holder. The legal heirs/complainants of deceased Siva Brahma Reddy approached opposite parties to settle the claim under the above policy but on 03-07-09, 1^st opposite party repudiated the claim on untenable grounds.  Hence, the action of 1^st opposite party amounts to deficiency of service, for which complainants suffered mentally and financially.  Hence, the complaint.

1^st opposite party filed its version, which is in brief as follows:

                Most of the averments mentioned in the complaint are false and the same is not maintainable in law.  This opposite party issued group personal accident policy to Kisan Credit Card Holders through 2^nd opposite party as they are borrowers/members of 3^rd opposite party.  After the death of deceased Vanukuri Siva Brahma Reddy, complainant through 2^nd opposite party claimed compensation.  Prior to that complainant made a claim of Rs.1,00,000/- through Chaitanya Godavari Grameena Bank for the self same accidental death as the deceased was also member under Janatha Personal Accident Group Insurance Policy No.150804/47/08/61/0000235 issued by this opposite party under the scheme Nirbhaya Gold Savings Bank Account Holders.  The deceased was one such account holder of CGG Bank and a sum of Rs.1,00,000/- was covered to each member under the said group insurance, as such the deceased was also covered under the said policy.  This opposite party appointed an investigator by name M.V.Ramana Kumar to make investigation into the claim and submit his report.  The investigator collected information in several ways and submitted report on 24-05-09.  As per the report of surveyor, the cause of death was genuine and after scrutinizing all the documents relating to the accident and driving license of the deceased, this opposite party settled the claim and paid a sum of Rs.1,00,000/- through a cheque dt.07-07-09 drawn on ING Vysya Bank Ltd., Tenali and the same was withdrawn by the complainant.

                The members in Janatha Perosnal Accident Group Insurance Scheme notwithstanding that the member joined more than one group insurance policy at one and the same period under the different policies in case of risk occurs, the victim is only entitled for the sum insured under only one policy and not under both under generally adopted guidelines of the controlling authority in the country.  As the deceased has two Janatha Perosnal Accident Group Insurance policies under Kisan Credit Card and Nirbhaya Gold Saving Bank Scheme at one and the same period and as the complainant has already claimed and received compensation under Group Insurance Personal Accident policy with Chaitanya Godavari Grameena Bank, complainants are not entitled to claim under this policy.  In view of the circumstances stated above this opposite party repudiated the claim through letter dt.03-07-09.  Hence, there is no deficiency of service on the part of this opposite party.

3^rd opposite party filed its version and the same is adopted by 2^nd opposite party, which is in brief as follows:

                The deceased Siva Brahma Reddy was a member of this opposite party. He was sanctioned an agricultural loan by this opposite party under Kisan Credit Card system under the personal accident benefit scheme introduced by 1^st opposite party.  The loanee under Kisan Credit Card system of this opposite party including the deceased were covered with the risk coverage of Rs.1,00,000/- under policy No.150800/47/08/43/00000017 dt.24-04-08 issued by 1^st opposite party and it was covered from 24-04-08 to 23-04-09. The policy was covered through 2^nd opposite party to which 3^rd opposite party is affiliated.  The role of 2^nd opposite party and 3^rd opposite party is only to oversee the coverage of insurance to the deceased who was a Kisan Credit Card Holder and loanee of this opposite party and to cover the risk of any eventuality by the insurance coverage for Rs.1,00,000/- with 1^st opposite party under personal accident benefit scheme.  The deceased died in a road accident on 13-02-09 during the subsistence of policy. The complainants submitted claim forms with required documents for the death of the insured to 1^st opposite party through proper channel in time.  The 1^st opposite party received claim papers but instead of settling the claim repudiated the claim on the filthy ground that the complainants have already preferred a claim at their branch at Tenali.  The contention of 1^st opposite party in repudiating the claim is not correct.  The settlement of claim is in between the complainants and 1^st opposite party.  Hence, this opposite party or 2^nd opposite party are not necessary parties and not liable for any claim.  Hence, there is no deficiency of service on the part of this opposite party. Hence, the complaint against this opposite party may be dismissed.

                Complainant, 1^st opposite party and 3^rd opposite party filed their respective affidavits in support of their versions reiterating the same and 2^nd opposite party also filed memo adopting the affidavit of 3^rd opposite party.

                On behalf of complainant Exs.A1 and A2 are marked and ob behalf of opposite parties 2 and 3 Exs.B1 to B4 are marked. No documents are marked on behalf of 1^st opposite party.

Now the points for consideration are

1. Whether there is any deficiency of service on the part of opposite parties?
2. To what relief the complainant is entitled to?

POINT No.1

                 The case of 1^st complainant is that her husband Siva Brahma Reddy during his life time joined as member of 3^rd opposite party and accordingly 2^nd opposite party issued passbook.  Opposite parties 2 and 3 have collected necessary policy premium covering risk to a tune of Rs.1,00,000/- under a policy No.150800/47/08/43/ 00000017 of 1^st opposite party, subsequently Siva Brahma Reddy died during February, 2009, therefore, the complainants made a claim under the policy and 1^st opposite party repudiated the claim on          03-09-09 with untenable grounds, which amounts to deficiency of service.

                The case of 1^st opposite party is that this opposite party issued a policy under Group Personal Accident Insurance Policy covering the Kisan Credit Card Holders through 2^nd opposite party as they are members of 3^rd opposite party and that after the death of deceased Vanukuri Siva Brahma Reddy, the complainant through 2^nd opposite party claimed compensation under the Group Insurance Policy viz. Kisan Credit Card Scheme Policy, prior to that 1^st complainant made a claim of Rs.1,00,000/- through Chaitanya Grameena Godavari Bank for the self save accidental death, as the deceased was also member under Janatha Personal Group Insurance Policy issued by the 1^st opposite party under the scheme Nirbaya Gold Savings Bank (NGSB) account holders since the deceased had an account under NGSB.  The risk of deceased was also covered under the said policy, this opposite party appointed investigator to make investigation into the claim and the investigator submitted his report on 24-05-09, that as per the report of the surveyor this opposite party settled and paid a sum of Rs.1,00,000/- through account payee cheque dt.07-07-09 drawn on ING Vysya Bank, Tenali and the same was withdrawn by the complainant, that since the deceased was covered under two different personal accident insurance policies, the insured is only entitled for one policy and not under both the policies under generally adopted guidelines of controlling authority in the country.  Therefore, the claim made by the 1^st complainant under the policy in question was repudiated by the 1^st opposite party.  Hence, there is no deficiency of service on the part of 1^st opposite party.

                The case of opposite parties 2 and 3 is that late Siva Brahma Reddy died in road accident on 13-02-09 that he was a member of 3^rd opposite party and was sanctioned agricultural loan by 3^rd opposite party under Kisan Credit Card and he was covered with the risk coverage of Rs.1,00,000/- under Kisan Credit Card through 2^nd opposite party and that complainants have not preferred any claim under the said policy issued by 1^st opposite party, that the settlement of claim is in between the complainant and 1^st opposite party and this  opposite party and 2^nd opposite party are not liable for any claim and that there is no deficiency of service on their part.  Hence, the complaint may be dismissed against these opposite parties.

                It is not in dispute that the deceased was a holder of Kisan Credit Card and that he is a member of 3^rd opposite party and that he was covered with a group personal accident policy to a tune of Rs.1,00,000/- and that the said Siva Brahma Reddy died in a road accident on 13-02-11.  On the death of late Vanukuri Siva Brahma Reddy complainants made a claim to 1^st opposite party through 2^nd opposite party for the insured amount of Rs.1,00,000/- and that the said claim of the complainants was repudiated by the 1^st opposite party under Ex.A2 dt.03-07-09.  The repudiation of the claim by 1^st opposite party under Ex.A2 is as follows:

                “……………… your claim has been repudiated because in our scrutiny of the claim papers submitted by the claimant, it was revealed that the claimant already preferred a JPA claim at our branch office, Tenali.  As per policy condition No.6 of JPA policy which reads as “If the insured shall at any time during the continuance of the policy be insured against similar JPA Insurance Policy with one or more insurers, then the maximum liability, of the insurer interest irrespective of such policies in force with one or more insurers shall be limited to a sum insured under one policy”        

                The above repudiation is made basing on the policy condition No.6 of JPA Policy.  1^st opposite party has not filed the said JPA policy in support of the repudiation made by 1^st opposite party to show that there is a condition as mentioned in Ex.A2 repudiation letter.  It was averred by 1^st opposite party that prior to the present claim i.e., claim in question they have settled the claim under Janatha Personal Accident Group Insurance Policy of Nirbaya Gold Saving Bank accent holders and paid a sum of Rs.1,00,000/- to the complainant under a payee cheque dt.07-07-09 drawn on ING Vysya Bank Ltd., Tenali on the basis of report of their survey.  The 1^st opposite party has not filed either the report of the surveyor or any document to show that they have settled the claim under Janatha Personal Accident Group as averred by 1^st opposite party.  Further it was averred by 1^st opposite party that the insured is only entitled to the benefits under one policy and not both under generally adopted guidelines of the controlling authority in the country.  1^st opposite party has not filed any guidelines in support of the above said version.  Since the deceased insured was a member of 3^rd opposite party having Kisan Credit Card, he was covered under Group Personal Accident Insurance Policy.  Further as the deceased insured having account in Nirbhaya Gold Savings Bank he was covered under Janatha Personal Accident Group Insurance Policy as alleged by 1^st opposite party.  The deceased insured paid premiums to both the policies and he became a holder of both the insurance policies as alleged by the 1^st opposite party.  As already stated above 1^st opposite party has not filed any document in support of its repudiation of claim or in support of the averments made by it.  In the absence of any documents in support of the repudiation and averments of 1^st opposite party, it cannot be said that there is any bar for settling the present claim in question for the death of the deceased.  Therefore, it can be safely concluded that as 1^st opposite party failed to prove that there is any bar to settle the claim in question, the complainants are entitled for the benefits of the claim in question.  Therefore, we are of the opinion that there is deficiency of service on the part of 1^st opposite party in settling the claim of complainant in question.  Opposite parties 2 and 3 are not concerned with the settlement of the claim made by the complainant.  Therefore, they are not liable for any claim and we find that there is no deficiency of service on the part of opposite parties 2 and 3.  Accordingly this point is answered in favour of complainants and against 1^st opposite party.

POINT No.2

                Complainants claimed a sum of Rs.25,000/- towards mental agony, Rs.5000/- towards legal expenses, Rs.10,000/- towards compensation and expenses and Rs.25,000/- towards interest besides the inured amount of Rs.1,00,000/-.  The amounts claimed under various heads except the insured amount are too high and that there is no basis to claim the said amounts.  Therefore, we are of the view that it is just and necessary to order directing 1^st opposite party to pay an amount of Rs.1,00,000/- being the insured amount together with interest thereon at 9% p.a. from the date of repudiation i.e., 03-07-09 till the date of realization and to pay an amount of Rs.5000/- towards compensation for the mental agony suffered by the complainants and Rs.1000/- towards costs of complaint would meet the ends of justice. Accordingly this issue is answered.

                In the result, the complaint is allowed in part in terms as indicated below:   

1. The 1^st opposite party is hereby directed to pay an amount of Rs.1,00,000/- (Rupees one lakh only) to the complainants together with interest thereon at 9% p.a. from the date of repudiation (03-07-09) till the date of realization.
2. The 1^st opposite party is further directed to pay an amount of Rs.5000/- (Rupees five thousand only) to the complainants towards compensation for the mental agony suffered by them.
3. The 1^st opposite party is further directed to pay an amount of Rs.1000/- (Rupees one thousand only) to the complainants towards costs of the complaint.
4. Complaint against opposite parties 2 and 3 is dismissed without cost.
5. The above orders shall be paid within a period of six weeks from the date of receipt of copy of this order, failing which the amount ordered in item No.2 also carry interest at 9% p.a. till realization .

Typed to my dictation by the Junior Steno, corrected by me and pronounced in the open Forum, this the 26^th day of September, 2011.    

       MEMBER                            MEMBER                            PRESIDENT

                                                 APPENDIX OF EVIDENCE

                                        DOCUMENTS MARKED

For Complainant:    

For opposite parties 2 & 3:                                                            

For 1^st opposite party :      NIL

                                                                                               PRESIDENT